West Nile Virus is one of the most frequently reported etiologies of viral encephalitis in the USA. West Nile Virus infections among hospitalized patients manifests most commonly as neuro-invasive disease. West Nile Virus has also been reported to cause myocarditis. Arrhythmia is not an uncommon occurrence in viral myocarditis. As cases of West Nile Virus increase, it is important that the index of suspicion also increase for this uncommon complication. Physicians who are caring for West Nile Virus-infected patients need to be aware of the possibility of West Nile Virus -related myocarditis. The question arises whether a patient with an established diagnosis of West Nile Virus -meningoencephalitis should be under continuous cardiac monitoring, bearing in mind the rare, but fatal, complication of cardiac arrhythmia secondary to viral myocarditis. We present a case report of a 65-year-old man who initially presented with fever, blurry vision, and decreased oral intake who subsequently suffered a fatal arrhythmia; further laboratory tests and autopsy findings revealed the patient likely had developed encephalitis and myocarditis secondary to West Nile Virus infection.